The Child-Pugh score (originally "Child-Turcotte" classification, later modified by Pugh) was developed in 1964 to assess the prognosis and operative mortality risk in patients with portal hypertension undergoing portosystemic shunt surgery. It incorporates five clinical and laboratory variables: bilirubin, albumin, prothrombin time (or INR), degree of ascites, and degree of hepatic encephalopathy — the latter two being subjective. Despite its age and subjective components, the Child-Pugh score remains clinically relevant and is used in HCC staging (BCLC), drug dosing decisions in liver disease, and assessment of surgical risk.